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Individual

TERRIS DIOR HIGHTOWER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAT, ATC

Contact information

Practice address
4400 UNIVERSITY DR, FAIRFAX, VA 22030-4444
(850) 791-8060
Mailing address
10495 BUTTERFIELD ST APT 32, MANASSAS, VA 20109-6848

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126003045
VA

Other

Enumeration date
01/09/2019
Last updated
01/09/2019
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